Journal article
Effect of Intracranial Stenosis Revascularization on Dynamic and Static Cerebral Autoregulation
Journal of vascular and interventional neurology, Vol.10(1), pp.1-6
06/2018
PMCID: PMC5999298
PMID: 29922396
Abstract
Severe intracranial stenosis might lead to acute cerebral ischemia. It is imperative to better assess patients who may benefit from immediate reperfusion and blood pressure management to prevent injury to peri-infarct tissue.
We assessed cerebral autoregulation using static and dynamic methods in an 81-year-old woman suffering acute cerebral ischemia from severe intracranial stenosis in the petrous segment of the left internal carotid artery (LICA).
Static cerebral autoregulation, which is evaluated by magnetic resonance imaging and magnetic resonance perfusion studies showed a progression of infarcts and a large perfusion-diffusion mismatch in the entire LICA territory between the second and third days after onset despite maximized medical therapy. Dynamic methods, including transfer function analysis and mean velocity index, demonstrated an increasingly impaired dynamic cerebral autoregulation (DCA) on the affected side between these days. Revascularization through acute intracranial stenting resulted in improved perfusion in the LICA territory and normalization of both dynamic and static cerebral autoregulation.
Thus, DCA, a noninvasive bedside method, may be useful in helping to identify and select patients with large-vessel flow-failure syndromes that would benefit from immediate revascularization of intracranial atherosclerotic disease.
Details
- Title: Subtitle
- Effect of Intracranial Stenosis Revascularization on Dynamic and Static Cerebral Autoregulation
- Creators
- Santiago Ortega-Gutierrez - University of Iowa, RadiologyEdgar A Samaniego - University of Iowa, NeurologyAmy Huang - Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Yale University School of Medicine, New Haven, CTArjun Masurkar - Department of Neurology, Columbia University, New York, NYBinbin Zheng-Lin - Stroke Division, Neurointerventional Surgery Section, Departments of Neurology, Neurosurgery and Radiology University of Iowa Hospitals and Clinics, Iowa, IAColin P Derdeyn - University of Iowa, RadiologyDavid Hasan - University of Iowa, NeurosurgeryRandolph Marshall - Department of Neurology, Columbia University, New York, NYNils Petersen - Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Yale University School of Medicine, New Haven, CT
- Resource Type
- Journal article
- Publication Details
- Journal of vascular and interventional neurology, Vol.10(1), pp.1-6
- PMID
- 29922396
- PMCID
- PMC5999298
- ISSN
- 1941-5893
- eISSN
- 1944-141X
- Grant note
- P30 AG008051 / NIA NIH HHS
- Language
- English
- Date published
- 06/2018
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery; Otolaryngology
- Record Identifier
- 9984071640502771
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